The Centers for Medicare and Medicaid Services (CMS) is working to address the Medicare Part D coverage gap for those receiving benefits for prescription drugs. The current plan includes a coverage gap, or “donut hole”, that suspends drug benefits when patients fall within certain limits of the plan. Early this year President Obama signed the Affordable Care Act which seeks to address the problem of the gap. The recently released CMS guidelines are the first step towards the eventual goal of closing the gap entirely.
CMS is signing up drug makers for the plan to provide additional discounts beginning in 2011. The program is designed to give consumers up to a 50% discount on brand name prescriptions and some generic prescriptions during the time that they fall into the coverage gap. The savings will be passed on to consumers when they purchase the drugs from their pharmacy.
The guidelines set up a third party administrator to oversee the discounts and to track the manufacturers’ compliance to the program. CMS has scheduled a public meeting for June 1 during which they hope to receive feedback about the plan.